Complementary and alternative therapies for PTSD in refugees and asylum seekers: a systematic review

BACKGROUND: Over 100 million people worldwide are displaced every year, including 26.3 million refugees and 4.5 million asylum seekers. Previous research has identified that up to 46% of asylum seekers and refugees (ASRs) use complementary and alternative therapies (CAT) in their lifetime. This study aimed to systematically review and summarise the findings from existing studies evaluating the effectiveness of practitioner-based complementary therapies in PTSD in ASR populations. METHODS: The study protocol was registered in PROSPERO [ID: CRD42022311069]. Electronic searches were conducted in MEDLINE, Embase, Google Scholar, PubMed, Cochrane Library, and Web of Science. Studies published in English that considered practitioner-based CAT in PTSD in adult ASRs were eligible. Results from quantitative studies were summarised using effect size and, for qualitative/mixed methods studies, narrative synthesis was conducted using thematic analysis. Quality assessment of the studies were conducted using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Of the total 605 studies identified in the search, 15 were included: quantitative (n = 11), qualitative (n = 2), and mixed methods (n = 3). Music therapy was identified as the most widely used intervention (five studies), followed by art therapy, body awareness therapy, meditation, yoga and spiritual therapy. Meditation, yoga and spiritual therapy were significantly associated with reduction in PTSD symptoms whereas the findings varied across the studies in relation to other therapies. Qualitative findings suggested that CAT interventions are acceptable to ASR populations. CONCLUSIONS: This study suggests that spiritual therapy, yoga, and meditation have a beneficial role in PTSD in ASR populations. However, the findings should be interpreted cautiously as the studies were small with considerable inter-study heterogeneity. KEY MESSAGES: • Practitioner based complementary and alternative therapies are acceptable to asylum seekers and refugees. • Spiritual therapy, yoga and meditation may have beneficial role in PTSD.